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Broglio SP, Register-Mihalik JK, Guskiewicz KM, Leddy JJ, Merriman A, Valovich McLeod TC. National Athletic Trainers' Association Bridge Statement: Management of Sport-Related Concussion. J Athl Train 2024; 59:225-242. [PMID: 38530653 DOI: 10.4085/1062-6050-0046.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To provide athletic trainers and team physicians with updated recommendations to the 2014 National Athletic Trainers' Association (NATA) concussion position statement regarding concussion management, specifically in the areas of education, assessment, prognostic factors, mental health, return to academics, physical activity, rest, treatment, and return to sport. BACKGROUND Athletic trainers have benefited from the 2 previous NATA position statements on concussion management, and although the most recent NATA position statement is a decade old, knowledge gains in the medical literature warrant updating several (but not all) recommendations. Furthermore, in various areas of the body of literature, current evidence now exists to address items not adequately addressed in the 2014 statement, necessitating the new recommendations. This document therefore serves as a bridge from the 2014 position statement to the current state of concussion evidence, recommendations from other organizations, and discrepancies between policy and practice. RECOMMENDATIONS These recommendations are intended to update the state of the evidence concerning the management of patients with sport-related concussion, specifically in the areas of education; assessment advances; prognostic recovery indicators; mental health considerations; academic considerations; and exercise, activity, and rehabilitation management strategies.
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Affiliation(s)
| | - Johna K Register-Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science and Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Kevin M Guskiewicz
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science and Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - John J Leddy
- UBMD Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY
| | | | - Tamara C Valovich McLeod
- Athletic Training Program, A.T. Still University, Mesa, AZ. Dr Guskiewicz is now at the Department of Kinesiology, Michigan State University, East Lansing
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Lam KC, Marshall AN, Bay RC, Wikstrom EA. Patient-Reported Outcomes at Return to Sport After Lateral Ankle Sprain Injuries: A Report From the Athletic Training Practice-Based Research Network. J Athl Train 2023; 58:627-634. [PMID: 36395375 PMCID: PMC10569251 DOI: 10.4085/1062-6050-0111.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
CONTEXT Limited evidence exists regarding the assessment of single-item patient-reported outcomes when patients are medically cleared to return to sport after a lateral ankle sprain (LAS) injury. OBJECTIVE To evaluate self-reports of improvement in health status, pain, function, and disability at return to sport after an LAS. DESIGN Descriptive study. SETTING Sixty-nine athletic training facilities across 24 states. PATIENTS OR OTHER PARTICIPANTS A total of 637 patients (males = 53.2%) who were diagnosed with an LAS, restricted from sport after injury, and subsequently medically cleared to return to sport within 60 days were included. MAIN OUTCOME MEASURE(S) Descriptive statistics were used to summarize scores for health status (Global Rating of Change), pain (Numeric Pain Rating Scale), function (Global Rating of Function), and disability (Global Rating of Disability). Mann-Whitney U tests were used to compare score differences between sexes. A Kaplan-Meier analysis was performed to provide a visual depiction of sex differences in the time to return to sport. RESULTS Most patients sustained an LAS injury while participating in basketball, football, or soccer and were cleared to return to sport 8 days after injury. More than two-thirds of patients reported a meaningful improvement in health status between the time of injury and return to sport. However, many noted deficits related to pain (65.1%), function (86.2%), or disability (35.8%) at return to sport. No differences were seen between males and females for pain (P = .90), function (P = .68), change in health status (P = .45), or disability (P = .21) at return to sport, although males returned to sport slightly sooner than females (P = .025). CONCLUSIONS Despite self-perceived improvements in health status since the time of injury, patients typically returned to sport with deficits in pain, function, and disability after an LAS. Patients may be returning to unrestricted sport participation before they feel their bodies have fully recovered from the injury.
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Affiliation(s)
- Kenneth C. Lam
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
| | | | - R. Curtis Bay
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
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Barber P, Pontillo M, Bellm E, Davies G. Objective and subjective measures to guide upper extremity return to sport testing: A modified Delphi survey. Phys Ther Sport 2023; 62:17-24. [PMID: 37300969 DOI: 10.1016/j.ptsp.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To identify which subjective and objective tests do content experts utilize to help guide return to sport (RTS) decision making for an athlete after an upper extremity (UE) injury? METHODS A modified Delphi survey was utilized, including content experts in UE rehabilitation. Survey items were identified based on a literature review identifying current best evidence and practice for UE RTS decision making. Content experts (n = 52) were identified, having a minimum of 10 years of experience with rehabilitation of UE athletic injuries, and 5 years of experience using an UE RTS algorithm to guide decision making. RESULTS Expert consensus was achieved on a combination of tests utilized within an UE RTS algorithm: 1. Tissue healing time frame is an important consideration in RTS decision making; 2. Patient reported outcome measures should be utilized specifically, DASH and NPRS 3. Strength is measured by handheld dynamometer and is an important consideration. 4. ROM should be utilized and is an important consideration. 5. Physical performance tests utilized include: Closed Kinetic Chain Upper Extremity Stability test, Seated shot-put test and lower extremity/core tests. CONCLUSIONS This survey reached expert consensus on which subjective and objective measures to utilize to evaluate RTS readiness after UE injury.
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Affiliation(s)
- Patrick Barber
- University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Eric Bellm
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - George Davies
- Georgia Southern University Physical Therapy Program, Savannah, GA, USA.
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Paraskevopoulos E, Pamboris GM, Papandreou M. The Changing Landscape in Upper Limb Sports Rehabilitation and Injury Prevention. Sports (Basel) 2023; 11:sports11040080. [PMID: 37104154 PMCID: PMC10145846 DOI: 10.3390/sports11040080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
This editorial aims to feature authors who intend to submit their research to this Special Issue of Sports entitled "Clinical Advances in Upper Limb Sports Rehabilitation and Injury Prevention" in areas that need special consideration [...].
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Affiliation(s)
- Eleftherios Paraskevopoulos
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
| | - George M Pamboris
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus
| | - Maria Papandreou
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
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Millet NJ, Snyder Valier AR, Eberman LE, Rivera MJ, Winkelmann ZK. The Knowledge and Use of the International Classification of Functioning, Disability and Health (ICF) Framework in Athletic Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5401. [PMID: 37048014 PMCID: PMC10094113 DOI: 10.3390/ijerph20075401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/22/2023] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
In 2015, the Strategic Alliance adopted the International Classification of Functioning, Disability, and Health (ICF) as the disablement model framework for delivery of and communication about patient care in athletic training. The purpose of this study was to examine athletic trainers' familiarity, knowledge, application, and implementation of the ICF framework. We used a cross-sectional online survey with 185 athletic trainers (age = 35 ± 9 y), which included 32 items focused on familiarity, knowledge, application, and implementation of the ICF framework. Most participants (n = 96, 51.9%) reported never learning about the ICF framework. During the knowledge assessment, participants scored 4.3 ± 2.7 out of 8, which is equivalent to 53.7%. For the sorting assessment, participants scored 10.9 ± 3.9 out of 18, which is equivalent to 60.5%. On the implementation matrix, the most frequently reported ICF tasks elicited by the athletic trainers included neuromusculoskeletal and movement, structure related to movement, and mobility. The most common 'never elicited' ICF tasks included voice and speech, sexual orientation, and structures related to genitourinary and reproductive system. Deficits related to the ICF framework exist. Athletic trainers reported low implementation across all ICF categories. The decision to not elicit information on these areas of health may reduce the ability to provide patient-centered healthcare.
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Affiliation(s)
- Nathaniel J. Millet
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | - Alison R. Snyder Valier
- School of Osteopathic Medicine, Department of Athletic Training, A.T. Still University, Mesa, AZ 85206, USA
| | - Lindsey E. Eberman
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN 47809, USA
| | - Matthew J. Rivera
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN 47809, USA
| | - Zachary K. Winkelmann
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
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Hessam M, Mousavi MH, Saadat M, Bliven KCH. Cross-Cultural Adaptation and Validation of the Persian Version of the Functional Arm Scale for Throwers. J Sport Rehabil 2023:1-8. [PMID: 36972704 DOI: 10.1123/jsr.2022-0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The Functional Arm Scale for Throwers (FAST) is a reliable and valid region-specific tool designed to evaluate health-related quality of life in throwing athletes with upper-extremity injuries. The purpose of this study was to adapt, translate, and evaluate the psychometric properties of the Persian version of the Functional Arm Scale (FAST-Persian) for use in throwing athletes. MATERIALS AND METHODS The study was conducted based on 5 steps of cross-cultural adaptation including forward translation, synthesis, backward translation, expert committee review, and pretesting. The final Persian questionnaire, along with Persian versions of Disabilities of the Arm, Shoulder, and Hand and Kerlan-Jobe Orthopedic Clinic questionnaires, was completed by 177 throwing athletes for validity analysis. After 7 to 14 days, the FAST-Persian was reanswered by 80 throwers, who had no changes in this time interval. Internal consistency and test retest reliability were used to evaluate reliability of the questionnaire. Standard error of measurement and smallest detectable changes were also calculated. Construct validity was determined by correlational analysis with Disabilities of the Arm, Shoulder, and Hand and Kerlan-Jobe Orthopedic Clinic questionnaires. Dimensionality was evaluated with factor analysis. RESULT Cronbachs alpha was .99, and the interclass correlation coefficient levels for total score and 5 subscales of the FAST-Persian ranged between .98 and .99. The standard error of measurement and smallest detectable changes were 3.17 and 8.80, respectively. The FAST-Persian had a high correlation with Disabilities of the Arm, Shoulder, and Hand (r = .98, P < .0001) and Kerlan-Jobe Orthopedic Clinic (r = .98, P < .0001) scores. Factor analysis revealed one factor with a total variance of 75.23%. CONCLUSION The FAST-Persian is a reliable and valid measurement tool that can be used to evaluate health-related quality of life in overhead athletes and throwers.
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Affiliation(s)
- Masumeh Hessam
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,Iran
- Physiotherapy Department, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,Iran
| | | | - Maryam Saadat
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,Iran
- Physiotherapy Department, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,Iran
| | - Kellie C Huxel Bliven
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ,USA
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Kubala JT, Pannill HL, Fasczewski KS, Rivera LA, Bouldin ED, Howard JS. Comparing the Primary Concerns of Injured Collegiate Athletes With the Content of Patient-Reported Outcome Measures. J Athl Train 2023; 58:252-260. [PMID: 35622954 PMCID: PMC10176840 DOI: 10.4085/1062-6050-0516.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Patient-reported outcome measures (PROMs) have been endorsed for providing patient-centered care. However, PROMs must represent their target populations. OBJECTIVE To identify the primary concerns of collegiate athletes experiencing injury and compare those with the content of established PROMs. DESIGN Cross-sectional study. SETTING Collegiate athletic training facilities. PATIENTS OR OTHER PARTICIPANTS Collegiate athletes experiencing injury (N = 149). MAIN OUTCOME MEASURE(S) Open-ended responses to the Measure Yourself Medical Outcome Profile were used to identify primary concerns, which were linked to International Classification of Functioning, Disability and Health taxonomy codes. Items of the Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; Lower Extremity Functional Scale; Knee injury and Osteoarthritis Outcome Score (KOOS); International Knee Documentation Committee Subjective Knee Form (IKDC); Foot and Ankle Ability Measure; Disabilities of the Arm, Shoulder, and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire were linked to International Classification of Functioning, Disability and Health codes. We calculated χ2 single-sample goodness-of-fit tests to determine if 70% of the content was shared between PROMs and participant-generated codes. RESULTS Participant-generated concerns were primarily related to sport participation (16%) and pain (23%). Chi-square tests showed that the Lower Extremity Functional Scale and Foot and Ankle Ability Measure presented significant content differences, with common participant-generated lower extremity responses at all levels. The Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; KOOS; IKDC; Disabilities of the Arm, Shoulder and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire did not have significant content differences for level 2 codes; still, significant differences were present for level 3 analyses except for the KOOS and IKDC (P < .001). All measures except the IKDC contained significant superfluous content (P < .05). CONCLUSIONS The presence of significant content differences supports clinician-perceived barriers regarding the relevance of established PROMs. However, the IKDC was a relevant and efficient PROM for evaluating the primary concerns of collegiate athletes experiencing lower extremity injury. Clinicians should consider using patient-generated measures to support coverage of patient-specific concerns in care.
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Affiliation(s)
| | - Heather L Pannill
- Rehabilitation Services, Appalachian Regional Healthcare System, Boone, NC
| | - Kimberly S Fasczewski
- Department of Public Health and Exercise Science, Appalachian State University, Boone, NC
| | - Laurie A Rivera
- Department of Rehabilitation Science, Appalachian State University, Boone, NC
| | - Erin D Bouldin
- Department of Internal Medicine, University of Utah, Salt Lake City
| | - Jennifer S Howard
- Department of Rehabilitation Science, Appalachian State University, Boone, NC
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Eliya Y, Qureshi AR, Kay J, Nagai K, Hoshino Y, de Sa D. Anatomical double-bundle anterior cruciate ligament reconstruction moderately improved tegner scores over the long-term: a systematic review and meta-analysis of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc 2023; 31:436-448. [PMID: 35838793 DOI: 10.1007/s00167-022-07046-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/09/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the effects of anatomical double-bundle (DB) versus single-bundle (SB) for anterior cruciate ligament (ACL) reconstruction in skeletally mature patients with ACL injuries. METHODS MEDLINE, EMBASE, and CENTRAL were searched from inception to February 7, 2022 were screened for randomized controlled trials. The Anatomic Anterior Cruciate Ligament Reconstruction Checklist was used to categorize studies as anatomic. A random-effects meta-analysis was conducted, with pooled results being summarized using mean difference (MD). Risk of Bias (RoB) was assessed using the RoB 2.0 tool. Certainty of evidence was rated using GRADE. RESULTS A search of 1371 unique articles yielded eight eligible trials, representing 735 patients (360 DB, 375 SB) with mean (SD) age of 28.5 (2.86) years and follow-up of 52.1 (36.2) months. Most trials had moderate to low RoB. Overall, DB was not significantly better than SB on Lysholm scores (MD = 0.52, 95% CI, - 1.80-2.85, p = 0.66; moderate certainty) or subjective International Knee Documentation Committee (IKDC) scores (MD = - 0.40, 95% CI, - 4.35-3.55, p = 0.84; moderate certainty). Tegner scores were significantly higher in SB than DB in the intermediate term (MD = - 0.72, 95% CI, - 1.10 to - 0.34, p = 0.0002; high certainty), while significantly higher in DB relative to SB in the long-term (MD = 0.52, 95% CI, 0.02-1.03, p = 0.04; high certainty). CONCLUSION DB ACL reconstruction significantly improves Tegner scores relative to SB ACL reconstruction over the long-term (t ≥ 5 years). Intermediate term Tegner scores favour SB reconstruction. In both durations, there was no clinically significant difference based on the pre-specified minimal clinically important difference of 1.0 point. There were also no significant differences in IKDC or Lysholm scores. Surgeons should consider anatomical DB ACL reconstruction as a result of long-term improvement in patient-reported outcomes. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Yousif Eliya
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Abdul-Rehman Qureshi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Jeffrey Kay
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Kanto Nagai
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Darren de Sa
- Department of Surgery, Division of Pediatric Orthopaedic Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
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Hoglund LT, Scalzitti DA, Bolgla LA, Jayaseelan DJ, Wainwright SF. Patient-Reported Outcome Measures for Adults and Adolescents with Patellofemoral Pain: A Systematic Review of Content Validity and Feasibility Using the COSMIN Methodology. J Orthop Sports Phys Ther 2023; 53:23-39. [PMID: 36251651 DOI: 10.2519/jospt.2022.11317] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE: To assess the content validity and feasibility of patient-reported outcome measures (PROMs) used to assess pain and function in adults and adolescents with patellofemoral pain (PFP). DESIGN: Systematic review. LITERATURE SEARCH: We searched the databases PubMed, CINAHL, Scopus, SPORTDiscus, and the Cochrane Library from inception to January 6, 2022. STUDY SELECTION CRITERIA: We included studies that described the development or evaluation of the content validity of English-language PROMs for PFP, as well as their translations and cultural adaptations to different languages. DATA SYNTHESIS: Using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology, we determined overall ratings and quality of evidence for the relevance, comprehensiveness, and comprehensibility of PROMs. We extracted data related to feasibility for clinical use (eg, administration time and scoring ease). RESULTS: Forty-three studies for 33 PROMs were included. The overall quality of most studies was "inadequate" due to failure to engage stakeholders and/or ensure adherence to rigorous qualitative research procedures. Of all PROMs evaluated, the Knee injury and Osteoarthritis Outcome Score-Patellofemoral subscale (KOOS-PF), was the only PROM with sufficient content validity components. Quality of evidence for content validity of the KOOS-PF was low. Most PROMs were rated feasible for clinical and research purposes. CONCLUSION: Most PROMs used to measure pain and function in patients with PFP have inadequate content validity. The KOOS-PF had the highest overall content validity. We recommend the KOOS-PF for evaluating pain and function (in research and clinical practice) in adults and adolescents with PFP. J Orthop Sports Phys Ther 2023;53(1):23-39. Epub: 18 October 2022. doi:10.2519/jospt.2022.11317.
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Snyder Valier AR, Huxel Bliven KC, Lam KC, Valovich McLeod TC. Patient-reported outcome measures as an outcome variable in sports medicine research. Front Sports Act Living 2022; 4:1006905. [PMID: 36406772 PMCID: PMC9666499 DOI: 10.3389/fspor.2022.1006905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
Injury prevention and rehabilitation research often address variables that would be considered clinician-oriented outcomes, such as strength, range of motion, laxity, and return-to-sport. While clinician-oriented variables are helpful in describing the physiological recovery from injury, they neglect the patient perspective and aspects of patient-centered care. Variables that capture patient perspective are essential when considering the impact of injury and recovery on the lives of patients. The inclusion of patient-reported outcome measures (PROMs) as dependent variables in sports medicine research, including injury prevention and rehabilitation research, provides a unique perspective regarding the patient's perception of their health status, the effectiveness of treatments, and other information that the patient deems important to their care. Over the last 20 years, there has been a significant increase in the use of PROMs in sports medicine research. The growing body of work gives opportunity to reflect on what has been done and to provide some ideas of how to strengthen the evidence moving forward. This mini-review will discuss ideas for the inclusion of PROMs in sports medicine research, with a focus on critical factors, gaps, and future directions in this area of research. Important elements of research with PROMs, including instrument selection, administration, and interpretation, will be discussed and areas for improvement, consideration, and standardization will be provided.
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Affiliation(s)
- Alison R. Snyder Valier
- Department of Athletic Training, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ, United States
| | - Kellie C. Huxel Bliven
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Kenneth C. Lam
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Tamara C. Valovich McLeod
- Department of Athletic Training, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ, United States,*Correspondence: Tamara C. Valovich McLeod
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11
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Snyder Valier AR, Rogo J, Bay RC, Valovich Mcleod TC. Interpreting patient-rated outcome measures in adolescent patients following concussion. Brain Inj 2022; 36:1258-1265. [PMID: 36107010 DOI: 10.1080/02699052.2022.2120209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To estimate scale scores for patient-reported outcome (PRO) measures that classify patients as improved or unimproved at days 3 and 10 post-concussion. METHODS Data from 187 adolescent patients who sustained a concussion (150 males, 32 females, 5 not reported) were analyzed. Patients completed the Pediatric Quality of Life Inventory (PedsQL), PedsQL Multidimensional Fatigue Scale (MFS), Headache Impact Test (HIT-6), and Global Rating of Change (GROC) on days 3 and 10 post-concussion. Dependent variables: PedsQL total score, 3 MFS subscale scores [general (MFS-GF), sleep (MFS-SLF), cognitive (MFS-CF) fatigue], and HIT-6 total score. Higher scores on PedsQL and MFS indicate better health; lower scores on HIT-6 indicate less impact on headache-related health. GROC ascertained patient-perceived magnitude of change in health status since concussion. Receiver Operating Characteristic Curve analyses estimated PRO cut-point scores that classified patients as improved or unimproved. RESULTS Day 3 PRO cut-points: PedsQL total = 90; MFS-GF = 73; MSF-CF = 85; MFS-SLF = 81; and HIT-6 total = 54. Day 10 PRO cut-points: PedsQL total = 91; MFS-GF = 85; MFS-CF = 85; MFS-SLF = 90; and HIT-6 total = 51. CONCLUSIONS Our results define PedsQL, MFS, and HIT-6 scores as they relate to perceived improvement following concussive injuries. Cut-point scale scores help clinicians interpret concussion PROs and make informed decisions during the management of patients with concussion.
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Affiliation(s)
- Alison R Snyder Valier
- Department of Athletic Training, A.T. Still University, Mesa, Arizona, USA.,Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, Arizona, USA.,Department of Research Support, A.T. Still University, Mesa, Arizona, USA.,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, Arizona, USA
| | - Jessica Rogo
- Department of Athletic Training, A.T. Still University, Mesa, Arizona, USA.,Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - R Curtis Bay
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Tamara C Valovich Mcleod
- Department of Athletic Training, A.T. Still University, Mesa, Arizona, USA.,Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, Arizona, USA.,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, Arizona, USA
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12
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Fleischhacker E, Maßen F, Gassner C, Helfen T. Sportverletzungen backstage – von der Akutversorgung zum exzellenten funktionellen Outcome. Notf Rett Med 2022. [DOI: 10.1007/s10049-022-01061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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13
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Webster KE, Klemm HJ, Feller JA. Choice of Patient-Reported Outcome Measures for Midterm Assessment After Anterior Cruciate Ligament Reconstruction Surgery. Am J Sports Med 2022; 50:2119-2124. [PMID: 35604331 DOI: 10.1177/03635465221099459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) have become increasingly popular for assessing subjective elements of a patient's condition. Two frequently used knee-related PROMs after anterior cruciate ligament reconstruction (ACLR) surgery are the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and the Knee injury and Osteoarthritis Outcome Score (KOOS). However, completing the full versions of both measures represents a considerable responder burden. PURPOSE To compare a variety of KOOS short forms with each other as well as the IKDC-SKF in a large sample of ACLR patients between 2 and 6 years after surgery. STUDY DESIGN Cohort study (Diagnosis); Level of evidence, 2. METHODS The KOOS and IKDC-SKF were administered between 2 and 6 years (mean, 3 years) after ACLR surgery to a cohort of 832 patients (men, n = 489; women, n = 343). Two single-item assessment numerical evaluations were also completed for knee function and satisfaction. The following short form versions were calculated from the full KOOS: the KOOS-12 short form, KOOS-Physical Function Short form (KOOS-PS), KOOS-Joint Replacement Short form (KOOS-JR), and KOOS-Global. Descriptive statistics were calculated for all PROMs and associations between measures were explored using nonparametric (Spearman rho) correlations. Floor or ceiling effects were considered present if >15% of patients reported the worst (floor effect) or best (ceiling effect) possible score. Age and sex comparisons were also made for each PROM. RESULTS Ceiling effects were present for all KOOS short form versions. They were highly evident for the KOOS-JR and KOOS-PS (37%-44%), but they were only marginally above the threshold for the KOOS-12 and KOOS-Global (16%). The KOOS-12 and KOOS-Global had the highest correlation with the IKDC-SKF but only explained 58% to 59% of the variance in scores. The KOOS-12 and KOOS-Global were very highly correlated (ρ = 0.98). Only moderate correlations were seen between the single-item assessments and the IKDC-SKF or various KOOS short forms. There was a negligible association between patient age and PROM scores, but there was no significant sex difference for any of the PROMs. CONCLUSION The IKDC-SKF together with either the KOOS-Global or KOOS-12 may provide a comprehensive range of knee-related PROMs with minimized responder burden at 2 to 6 years after ACLR.
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Affiliation(s)
- Kate E Webster
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Haydn J Klemm
- OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia
| | - Julian A Feller
- OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia
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14
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Association of Ankle Sprain Frequency With Body Mass and Self-Reported Function: A Pooled Multisite Analysis. J Sport Rehabil 2022; 31:1000-1005. [PMID: 35618300 DOI: 10.1123/jsr.2021-0453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT Ankle sprains result in pain and disability. While factors such as body mass and prior injury contribute to subsequent injury, the association of the number of ankle sprains on body anthropometrics and self-reported function are unclear in this population. Therefore, the purpose of this investigation was to assess differences in anthropometric measurements and self-reported function between the number of ankle sprains utilizing a large, pooled data set. DESIGN Cross-sectional. METHODS Data were pooled from 14 studies (total N = 412) collected by the Chronic Ankle Instability Outcomes Network. Participants were categorized by the number of self-reported sprains. Anthropometric data and self-reported function were compared between those who reported a single versus >1 ankle sprain as well as among groups of those who had 1, 2, 3, 4, and ≥5 ankle sprains, respectively. RESULTS Those who had >1 ankle sprain had higher mass (P = .001, d = 0.33) and body mass index (P = .002, d = 0.32) and lower Foot and Ankle Ability Measure-Activities of Daily Living (P < .001, r = .22), Foot and Ankle Ability Measure-Sport (P < .001, r = .33), and Cumberland Ankle Instability Tool (P < .001, r = .34) scores compared to the single ankle sprain group. Those who had a single ankle sprain weighed less than those who reported ≥5 sprains (P = .008, d = 0.42) and had a lower body mass index than those who reported 2 sprains (P = .031, d = 0.45). CONCLUSIONS Some individuals with a history of multiple ankle sprains had higher body mass and self-reported disability compared to those with a single sprain, factors that are likely interrelated. Due to the potential for long-term health concerns associated with ankle sprains, clinicians should incorporate patient education and interventions that promote physical activity, healthy dietary intake, and optimize function as part of comprehensive patient-centered care.
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Wang M, Li L. Research and Implementation of Distributed Computing Management System for College Students' Sports Health Based on Integrated Regional Collaborative Medical Care. Occup Ther Int 2022; 2022:9306200. [PMID: 35655945 PMCID: PMC9132689 DOI: 10.1155/2022/9306200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022] Open
Abstract
This paper constructs and applies a university student sports health management system through the theory of integrated regional collaborative medical care and distributed computing technology. Firstly, it analyzes the current situation and problems of cross-regional medical care, the root causes, and the corresponding business scenarios, reflecting the development trend of cross-regional medical care, in the light of the current practical needs of cross-regional medical care. In response to the strong demand for cross-regional medical care, this paper gives the overall design of the distributed computing system, for the deployment and architecture of the cross-regional platform; the registration of cross-regional patients, regional platforms, and health events and documents; and data exchange, service integration, and process integration, etc. The corresponding design is given. The research was conducted on several medical institutions to refine the functional requirements for the construction of the regional collaborative medical platform, and the requirements were analyzed to present the research results of the collaborative medical project. Based on this, requirements were made for the preparation of the project construction data center and medical institutions, and the remote consultation and two-way referral modules of the distributed collaborative medical platform were designed, which are processed and analyzed through a system composed of multiple servers. The results are returned to the user, and the design results were tested for functionality, compatibility, security, and other usability tests. The necessity and feasibility of the college physical health test data platform were analyzed. Students have various needs for physical test data management, the necessity of designing the college physical health test data platform, and the feasibility of the college physical health test data platform in terms of technical means, theoretical basis, and social environment.
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Affiliation(s)
- Mian Wang
- School of Science and Technology, Nanchang University, Jiangxi 330006, China
| | - Lijuan Li
- Sports Institute, Nanchang University, Jiangxi 330006, China
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16
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Collegiate Athletic Trainers’ Use of Behavioral Health Screening Tools. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2022. [DOI: 10.1123/ijatt.2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Screening for behavioral health (BH) concerns is important for early identification, referral, and management. The purpose of this study was to examine collegiate athletic trainers use of BH screening tools. We used a cross-sectional design with a web-based survey. Approximately 49% (n = 198/405) of participants used BH screening tools in their practice; the most used tools were PHQ-9 (n = 112/198, 56.6%) and GAD-7 (n = 54/198, 27.3%). Practice integration considerations and practice advancements occurred as a result of BH screening. Given rising incidence and severity of BH conditions in collegiate athletics, more training on screening and prevention is needed.
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17
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Kim Y, Kang D, Kang E, Lim J, Kim S, Nam H, Shim S, Lee M, Moon YW, Lim SJ, Sung KS, Cho J. Psychometric validation of the Korean version of PROMIS 29 Profile V2.1 among patients with lower extremity problems. BMC Sports Sci Med Rehabil 2021; 13:148. [PMID: 34819153 PMCID: PMC8614031 DOI: 10.1186/s13102-021-00374-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022]
Abstract
Background Patients with lower extremity problems (LEP) commonly experience functional loss, pain, decreased range of motion, inadequacy in daily living activities, and structural change in radiographic evaluations. However, the traditional patient-reported outcome measurement which focused on symptoms, had a limited scope of applicability. This study aimed to validate the psychometric properties of the Korean version of PROMIS-29 Profile v2.1 (K-PROMIS-29 V2.1), a multi-dimensional measure for assessing generic profile health-related quality-of-life (HRQoL) in a sample of patients with lower extremity problems (LEP). Methods Participants were recruited from the orthopedic outpatient clinics at the Samsung Medical Center in Seoul, South Korea from September to October 2018. Participants completed a survey questionnaire that included the K-PROMIS-29 V2.1 and the SF-36v2. Principal component analysis (PCA) and confirmatory factor analysis (CFA) and Pearson’s correlations were used to evaluate the reliability and validity of the K-PROMIS-29 V2.1. Results A total of 299 participants were enrolled in the study and 258 (86%) completed the study questionnaire. The mean age (SD) of the participants was 56.6 (14.5) and 32.3%, 29.8, and 25.2% of the study participants visited outpatient clinics for foot, knee, and hip problems respectively. The Cronbach’s alpha coefficients of 7 sub-domains in K-PROMIS-29 V2.1 ranged from 0.80 to 0.95, indicating satisfactory internal consistency. In CFA, the goodness-of-fit indices were high (CFI = 0.937 and SRMR = 0.061). High to moderate correlations were found between comparable subscales of the K-PROMIS-29 V2.1 and subscales of the SF-36v2 (r = 0.55–0.70). Conclusions The K-PROMIS-29 V2.1 is a reliable and valid measure for assessing a broad range of health-related quality-of-life domains in patients with LEP. It would reflect the real-life symptoms experienced by patients with LEP. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00374-1.
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Affiliation(s)
- Youngha Kim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Danbee Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-Gu, 06351, Seoul, South Korea
| | - Eunjee Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.,Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jihyun Lim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Sooyeon Kim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-Gu, 06351, Seoul, South Korea
| | - Heesu Nam
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-Gu, 06351, Seoul, South Korea
| | - Sungkeun Shim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Mangyeong Lee
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Young-Wan Moon
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-Gu, 06351, Seoul, South Korea
| | - Seung-Jae Lim
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-Gu, 06351, Seoul, South Korea
| | - Ki-Sun Sung
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-Gu, 06351, Seoul, South Korea.
| | - Juhee Cho
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea. .,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-Gu, 06351, Seoul, South Korea. .,Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. .,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. .,Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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18
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Lam KC, Anderson BE, Welch Bacon CE. The critical need for advanced training of electronic records use: implications for clinical practice, education, and the advancement of athletic training. J Athl Train 2021; 57:599-605. [PMID: 34793597 DOI: 10.4085/1062-6050-298-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The effective use of electronic records (ie, electronic health/medical records) is essential to professional initiatives and the overall advancement of the athletic training profession. However, evidence suggests comprehensive patient care documentation and wide-spread use of electronic records is still limited in athletic training. The lack of formal training and education for clinicians and students are often cited as primary barriers to electronic records use. Other healthcare disciplines have used academic electronic health records (AEHR) systems to address these barriers with promising results. OBJECTIVES To identify common challenges associated with the effective use of electronic records in clinical practice, discuss how an AEHR can address these challenges and encourage more effective use of electronic records, and describe strategies for deploying AEHRs within the athletic training profession. DESCRIPTION The AEHR is an electronic records system specifically designed for educational use to support simulation learning among all types of learners (eg, practicing clinicians, students). Mimicking the form and function of an EHR, the AEHR offers various educational tasks including patient care documentation projects, critical reviews of standardized patient cases, and assessments of patient care data for quality improvement efforts. Clinical and Research Advantages: Recent evidence suggests the use of an AEHR can improve knowledge and enhance skills. Specifically, AEHR use has been associated with enhanced attitudes toward EHR technology, enhanced informatics competencies, and improved documentation skills. Also, the use of an AEHR has been associated with improved critical thinking and decision-making skills. AEHRs appear to be valuable tools for health professions education and athletic training stands to benefit from AEHR use to better train and upskill clinicians and students alike for clinical practice. Although the implementation of an AEHR will require much time and large-scale coordinated efforts, it will be a worthy investment to address current challenges and advance the athletic training profession.
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Affiliation(s)
- Kenneth C Lam
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa
| | - Barton E Anderson
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa
| | - Cailee E Welch Bacon
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa
- School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa
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19
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Marshall AN, Root HJ, Valovich McLeod TC, Lam KC. Patient-reported outcome measures for pediatric patients with sport-related injuries: a systematic review. J Athl Train 2021; 57:371-384. [PMID: 34478555 DOI: 10.4085/1062-6050-0598.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Despite a call to incorporate PROMs into all aspects of health care, little is known about which instruments are best-suited for a pediatric patient population with sport-related injury. The objective of this article was to perform a systematic review of the currently available evidence to determine which patient-reported outcome measures (PROMs) are used for pediatric patients with sports-related injuries, and to identify the associated psychometric properties and considerations for clinical utility. We conducted a literature search for articles on PROMs used in the pediatric population through electronic databases and via a manual search of reference lists and authors between 1990 and 2020. Articles were grouped based off of the PROM(s) included, and considerations for clinical utility and psychometric properties were extracted from each article. Thirty-nine articles were included in this review, from which twenty-two PROMs were identified - twelve PROMs were developed specifically for the pediatric population, four were modified versions of an adult scale, and six instruments were adult measures used in a pediatric population. Of the PROMs included in this review, the Oxford Ankle Foot Questionnaire for Children (OxAFQ-C) and the Pediatric Quality of Life Inventory (PedsQL) were the most comprehensive in their development and assessment. Several outcome measures used for pediatric patients had missing or inadequate measurement properties and considerations for clinical utility, particularly in regards to readability, responsiveness and interpretability. Clinicians and researchers should consider the measure's feasibility, acceptability, appropriateness and psychometric psychometric properties when selecting a PROM for use with the pediatric population.
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Affiliation(s)
- Ashley N Marshall
- 1 Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina, USA
| | - Hayley J Root
- 2 Department of Physical Therapy & Athletic Training, Northern Arizona University, Phoenix, Arizona, USA
| | - Tamara C Valovich McLeod
- 3 Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, Arizona, USA.,4 Athletic Training Programs and School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, Arizona, USA
| | - Kenneth C Lam
- 3 Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, Arizona, USA
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20
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Skelley NW, Kurtenbach C, Kimber K, Piatt B, Noonan B. Return-to-Sport Review for Current Cartilage Treatments. J Knee Surg 2021; 34:39-46. [PMID: 33389739 DOI: 10.1055/s-0040-1721669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The return to play outcome is an important measure for orthopaedic sports medicine treatments. This variable is especially important when discussing cartilage treatments because there are many different cartilage options available to athletes with articular injuries and this population is particularly interested in the ability to return to activities. Although many outcome variables are considered in any surgical procedure, the return-to-sport variable is focused on an active population and can be tailored to that patient's sport-specific goals. In this article, we will review some of the most recent and up-to-date articles describing return-to-sport outcomes for various knee cartilage treatments. This article will focus on the most common current knee cartilage treatments including microfracture, autologous chondrocyte implantation, osteochondral autograft transplant, and osteochondral allograft transplantation.
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Affiliation(s)
- Nathan W Skelley
- Sanford Health Orthopaedics and Sports Medicine, University of South Dakota Medical Center, Sioux Falls, South Dakota
| | - Chad Kurtenbach
- Sanford Health Orthopaedics and Sports Medicine, University of South Dakota Medical Center, Sioux Falls, South Dakota
| | - Kristofer Kimber
- Sanford Health Orthopaedics and Sports Medicine, University of South Dakota Medical Center, Sioux Falls, South Dakota
| | - Bruce Piatt
- Sanford Health Orthopaedics and Sports Medicine, University of South Dakota Medical Center, Sioux Falls, South Dakota
| | - Benjamin Noonan
- Sanford Health Orthopaedics and Sports Medicine, University of South Dakota Medical Center, Sioux Falls, South Dakota
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